Radiofrequency ablation versus repeat resection for recurrent hepatocellular carcinoma (≤ 5 cm) after initial curative resection

Feng, Yuemin; Wu, Hao; Huang, Daniel Q.; Xu, Cheng-Hui; Zheng, Hang; Maeda, Manabu; Zhao, Xinya; Wang, Le; Xiao, Feng; Lv, Huanran; Liu, Tiantian; Qi, Jianni; Li, Jie; Zhong, Ning; Wang, Chuanxi; Hong, Feng; Liang, Bo; Ren, Wei; Qin, Chengyong; Nguyen, Mindie H.; Zhu, Qiang

doi:10.1007/s00330-020-06990-8

Cited by 39 publications

(63 citation statements)

References 34 publications

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“…The study selection process is shown in Figure 1. Ultimately, 18 studies (1 RCT, 3 propensity score matching-non RCTs [PSM-NRCTs], 14 NRCTs) compared LR with RFA for RHCC were included in our meta-analysis [10][11][12][13][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. The included studies evaluated a total of 1991 patients with recurrence of HCC; of these, 862 patients underwent LR, and 1129 patients underwent RFA.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The pooled OS was compared based on 16 studies which incorporated 1902 patients (817 patients for LR, 1085 patients for RFA) [10][11][12][13][24][25][26][27][28][30][31][32][33][34][35][36]. The pooled HR for OS demonstrated that LR had significantly better OS than RFA in recurrent HCC (HR, 0.81; 95% CI, 0.68-0.95; p < .001; I 2 ¼ 0.0%) (Figure 2(A)).…”

Section: Overall Survivalmentioning

confidence: 99%

“…Data on DFS were available in 10 studies which incorporated 1075 patients (435 patients for LR, 640 patients for RFA) [11,12,24,26,30,[32][33][34][35][36]. The pooled HR showed no significant difference in DFS between the LR and RFA during the whole follow-up period (HR, 0.90; 95% CI, 0.76-1.07, p ¼ .217, I 2 ¼ 0.0%) (Figure 4(A)).…”

Section: Disease-free Survivalmentioning

confidence: 99%

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Liver resection versus radiofrequency ablation for recurrent hepatocellular carcinoma: a systematic review and meta-analysis

Yao

Tan

et al. 2021

International Journal of Hyperthermia

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Background & aims: Liver resection (LR) and radiofrequency ablation (RFA) are commonly used for the treatment of recurrent hepatocellular carcinoma (HCC), but the optimal treatment modality remains unclear. We aimed to compare the efficacy and safety of LR vs RFA for recurrent HCC. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant studies. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes were major complications and hospital stay. Results: Eighteen studies with 1991 patients with recurrent HCC were included. The pooled hazard ratio (HR) for OS demonstrated that LR had significantly better OS than RFA in recurrent HCC (HR, 0.81; 95% confidence interval [CI], 0.68-0.95). Specifically, LR was associated with higher 2-, 3-and 4year OS rates compared with RFA. The pooled HR for DFS showed no significant difference between LR and RFA during the whole follow-up period (HR, 0.90; 95% CI, 0.76-1.07). However, LR was associated with significantly higher 2-to 5-year DFS rates compared to RFA. LR was also associated with more major complications (p < .001) and longer hospital stay (p < .001). Subgroup analyses demonstrated that LR and RFA had similar efficacy in patients with recurrent tumors less than 3 cm or patients presenting three or fewer recurrent nodules. Conclusion: LR could provide better long-term survival outcomes than RFA for recurrent HCC patients, while RFA has a higher safety profile. RFA can be a good alternative to LR for patients with small-sized recurrence or patients with a limited number of recurrent nodules. However, as tumor size increases, LR tends to be more efficacious.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Overall Survivalmentioning

confidence: 99%

Section: Disease-free Survivalmentioning

confidence: 99%

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Liver resection versus radiofrequency ablation for recurrent hepatocellular carcinoma: a systematic review and meta-analysis

Yao

Tan

et al. 2021

International Journal of Hyperthermia

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“…Radiofrequency ablation (RFA) is a curative locoregional treatment for HCC that can be performed even in patients with unresectable HCC who have poor liver function. Recent studies reported no differences in the recurrence‐free survival values following RFA versus hepatectomy 7,8 . Therefore, RFA is now more widely performed as a curative treatment option for HCC.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies reported no differences in the recurrence-free survival values following RFA versus hepatectomy. 7,8 Therefore, RFA is now more widely performed as a curative treatment option for HCC.…”

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confidence: 99%

Safety and efficacy of percutaneous radiofrequency ablation for hepatocellular carcinoma patients with haemophilia

et al. 2020

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Haemophilia is an X‐linked inherited bleeding disorder caused by coagulation factor deficiency. Hepatocellular carcinoma (HCC) is a major complication associated with the disease. No study thus far has investigated the safety and efficacy of percutaneous radiofrequency ablation (RFA) for HCC in patients with haemophilia. Aim This study aimed to evaluate the safety and efficacy of RFA for HCC in haemophilia patients. Methods From July 2008 to June 2019, 217 patients with HCC underwent 300 RFA sessions. Of these, 18 sessions were performed in ten haemophilia patients (H group) and 282 in 207 non‐haemophilia patients (NH group). The patients' characteristics, incidence of haemorrhagic complications and rates of local tumour recurrence were compared between the groups. Results A majority of the haemophilia patients received clotting factor concentrate replacement therapy before and after RFA treatment, with the aim of reaching a plasma clotting factor level of higher than 60%–80%. Twelve haemorrhagic complications were observed in the NH group (4.2%; 12/282). Major bleeding requiring control procedures was observed in two patients and minor bleeding with careful observation was noted in ten patients. No bleeding complications were observed in the H group (0/18). There were no significant differences in the 5‐year local tumour recurrence rates after RFA treatment between the groups (35.0% in the H group and 32.1% in the NH group). Conclusion RFA could be an effective and a safe method for HCC treatment in patients with haemophilia.

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Repeat hepatic resection combined with intraoperative radiofrequency ablation versus repeat hepatic resection alone for recurrent and multiple hepatocellular carcinoma patients meeting the Barcelona Clinic Liver Cancer stage A: A propensity score‐matched analysis

Huang

et al. 2023

Cancer Medicine

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Background The surgical indications and therapeutic strategies for early‐stage multifocal and recurrent hepatocellular carcinoma (rHCC) remain controversial. This study compared the long‐term outcome of patients with recurrent and multifocal HCC meeting the Barcelona Clinic Liver Cancer (BCLC) stage A with repeat hepatectomy (RH) and RH combined with intraoperative radiofrequency ablation (RFA). Methods A total of 109 consecutive patients with intrahepatic early‐stage multifocal rHCC within BCLC stage A following RH or RH + RFA were retrospectively collected from April 2010 to May 2020. Propensity score matching, subgroup analysis, and univariate and multivariate analyses were performed. Overall survival after recurrence (rOS) and recurrence‐free survival after recurrence (rRFS) were calculated by Kaplan–Meier analysis. Results The 1‐, 3‐, and 5‐year rOS and rRFS of the combination group and the RH group were similar ( p = .699; p = .587, respectively). The similar results also appeared in matched population. Subgroup analyses indicated that there was no significant difference between patients with two tumors and three tumors, but the RH group was associated with better rRFS than the combination group for patients whose tumors were located in the same lobe ( p = .045). Multivariate analysis revealed that time to recurrence (TTR) ≤ 2 years and intrahepatic metastasis (IM) pathologically were independent risk factors. Conclusions For multifocal rHCC patients meeting the BCLC stage A, tumor which is difficult to be surgically resected could be treated by RFA in order to avoid complications or bleeding. Tumors which were located in the same lobe may be more suitable to be treated by RH alone.

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Radiofrequency ablation versus repeat resection for recurrent hepatocellular carcinoma (≤ 5 cm) after initial curative resection

Cited by 39 publications

References 34 publications

Liver resection versus radiofrequency ablation for recurrent hepatocellular carcinoma: a systematic review and meta-analysis

Liver resection versus radiofrequency ablation for recurrent hepatocellular carcinoma: a systematic review and meta-analysis

Safety and efficacy of percutaneous radiofrequency ablation for hepatocellular carcinoma patients with haemophilia

Repeat hepatic resection combined with intraoperative radiofrequency ablation versus repeat hepatic resection alone for recurrent and multiple hepatocellular carcinoma patients meeting the Barcelona Clinic Liver Cancer stage A: A propensity score‐matched analysis

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